It’s that time of year, the dreaded cold and flu season. Many of us are used to heading for the doctor’s office at the first change of color in our mucus or for persistent coughs. Sometimes, these trips are proper. I had an upper respiratory infection the week before Christmas and my doctor gave me symptom-managing prescriptions that made life bearable. She did not, however, give me antibiotics; this was also the proper course of action. Antibiotic overuse creates health problems and isn’t always beneficial in treating the original illness.
Take my case as example. My URI was entirely viral. Antibiotics are absolutely useless against viral infections; one may as well not take anything. Yet, patients continue to demand antibiotics when they’re not appropriate and doctors continue to prescribe them. American College of Physicians President Dr. Wayne J. Riley, an internal medicine professor at Vanderbilt University is hoping to change this practice.
“Antibiotics are terrific. Thank God we have them for really bad things. But we need to be judicious in the way we use them,” he says. Instead, he suggests tips for doctors to avoid prescribing unnecessary antibiotics and how they may best manage patients who demand them.
Medical science has debunked the theory that changes in mucus color automatically necessitate antibiotics. You can get the infamous “milky green” from a viral infection, too. Other tips include changing the description of the illness. Instead of referring to bronchitis, which sounds scary and awful, Dr. Riley suggests calling it a “chest cold.” I am not in favor of dumbing down patient care. I prefer patient education.
One of Dr. Riley’s ideas that I can fully support involves prescriptions for over-the-counter and non-OTC symptom managing products and home remedies. During my recent illness, my doctor prescribed a codeine-based cough syrup and OTC symptom-reducing items.
Dr. Riley explains, “We’re calling for the symptomatic prescription pad.” Rather than the traditional pad, these are informational sheets advising the use of humidifiers, drinking a lot of fluid and getting rest. They also have room for doctors to jot down directions for OTC products and to advise when patients to return if there’s no improvement.
According to the CDC antibiotic-resistant bacteria cause around 2M illnesses and as many as 23,000 deaths in the U.S. every year. Overuse of antibiotics, whether prescribed or in our food, is a leading cause of these powerful drugs becoming ineffective.
While the CDC is seeing a reduction in over-prescribing antibiotics to children, adult overuse is still a big problem. This is particularly true of respiratory illnesses, according to Dr. Lauri Hicks, the head of the CDC’s “Get Smart” antibiotic education campaign.
The CDC and the American College of Physicians recently released guidelines to help doctors curb overuse of antibiotics. They’re included below:
“Among the advice, published in Annals of Internal Medicine:
—Acute bronchitis is airway inflammation, irritation that makes you cough, sometimes as long as six weeks. The guidelines say not to perform special testing or prescribe antibiotics unless pneumonia is suspected, something often accompanied by a fast heartbeat, fever or abnormal breathing sounds.
Over-the-counter symptom relief includes cough suppressants such as dextromethorphan; mucus-thinning expectorants such as guaifenesin; and antihistamines or decongestants.
—Sore throats are hugely common but adults are far less likely than children to have the strep throat that requires an antibiotic. A rapid strep test is available if patients have suspicious symptoms such as persistent fever, night sweats or swollen tonsils.
Pain-relieving options for adults include aspirin, acetaminophen, nonsteroidal anti-inflammatory drugs such as ibuprofen, and throat lozenges.
—Sinus infections can be very painful but usually clear up without antibiotics even if bacteria are to blame. The guidelines say antibiotics should be reserved for patients with no signs of improvement after 10 days, severe symptoms such as fever higher than 102, or what’s called double-sickening, when someone starts to recover and then gets worse.
Possible symptom relievers include decongestants, nasal sprays, saline nasal irrigation and pain medications.”